Abstract

For families faced with a serious or complex medical problem, the choice of hospital can be critical. Yet they had few tools or resources beyond a doctor’s recommendation to inform their decision until 1990, when U.S. News & World Report introduced “Best Hospitals.” Initially, the annual assessments took the form of alphabetized lists in 12 specialties, but in 1993 and thereafter, hospitals were ranked within each specialty. This year’s “Best Hospitals” draws from a universe of 4,852 medical facilities.* We use the hospital definitions supplied by the American Hospital Association (AHA) in its annual survey, which is the source of some of the data used in the Best Hospitals rankings. Under rare circumstances, we will combine two or more AHA hospitals for rankings purposes, when the hospitals function as one but report separately to the AHA for specific, meaningful, and verifiable reasons.

In 12 of the 16 adult specialty rankings, hospitals receive a composite score that is based on data from multiple sources. (“Best Children’s Hospitals,”† which ranks hospitals in 10 pediatric specialties, is a separate project.) The rankings and key portions of the accompanying data are published in a print edition; both ranked and unranked hospitals, with additional data, are published online at www.usnews.com/besthospitals.

Central to understanding the rankings is that they were developed and the specialties chosen to help consumers determine which hospitals provide the best care for the most serious or complicated medical conditions and procedures—pancreatic cancer or replacement of a heart valve in an elderly patient with comorbidities, for example. Medical centers that excel in relatively commonplace conditions and procedures, such as noninvasive breast cancer or uncomplicated knee replacement, are not the focus.

The underlying methodology for the Best Hospitals rankings was the work of the National Opinion Research Center (NORC) at the University of Chicago in the early 1990s. NORC collected the data and compiled the rankings from 1993 to 2004. In 2005, RTI International‡ in Research Triangle Park, N.C., began producing the rankings. The methodology has been refined as opportunities appeared. Larger-scale enhancements are always under consideration. In 2009, a new measure related to patient safety was introduced. The basic eligibility requirements also were modified, potentially increasing the number of rankable hospitals.